Health literacy changes lives in Goromonzi

Health literacy changes lives in Goromonzi

March 5, 2015 in News

HEALTH literacy has helped improve standards of health in the Chikwaka rural area in Goromonzi district where community health workers (CHWs) are playing a leading role in encouraging locals to embrace best health care practices.

By Caiphas Chimhete

As a result of health literacy offered by CHWs such as villages health workers (VHWs), health literacy facilitators (HLFs) and health centre committees (HCCs), community participation in health programmes has also increased in the area.

Even the relationship between the community and staff at Mwanza rural health centre has greatly improved leading to an upsurge of the number of people seeking health services at the clinic.The clinic now attends to between 500 and 650 patients per month up from an average of 350 patients per month two years ago.

Unlike before, pregnant mothers now prefer to give birth at the health centre.

The local community, with the help from the Community Working Group on Health (CWGH), is currently building a waiting mothers’ shelter at the clinic to ensure that pregnant women nearing full term from the catchment can stay at the home while waiting to give birthin a clean and safe environment with aid of a skilled birth attendant.

The Mwanza Clinic waiting mothers’ home, an initiative of the community, is expected to open its doors to pregnant women this year.

Mwanza Clinic nurse-in-charge, Francis Nyakani said home deliveries in the area had significantly gone down as a direct result of intensive sensitisation efforts by CHWs on the importance of giving birth at a health centre. Presently, the clinic handles about 24 deliveries up from average of 15 deliveries per month two years ago.

“There has been a big improvement on health seeking behavior because of sensitisation efforts by community health workers,” said Nyakani. “Most women are now informed about the importance of delivering at a health centre and we give credit to our HCC members.”

He added that people living with HIV/Aids were no longer afraid of revealing their status because the community now treats the disease like any other illness.

“People living with HIV speak openly about their status in this community and they also have forums where they teach others about the importance of things like abstinence and protection,” he said.

Goromonzi is one of the districts where CWGH and Save the Children in partnership with the Ministry of Health and Child Care are implementing the three-year Strengthening Community Participation in Health programme.

The programme, which is being implemented in eight provinces in Zimbabwe, is designed to strengthen community participation in health for improved Maternal, Neonatal and Child Health (MNCH) outcomes by raising community’s awareness about their health entitlements.

“It is now easy to address our problems as a community because we were trained as HCC members starting in 2010 by CWGH,” said Mwanza Clinic HCC chairman Everisto Mupambawatye. “Ican safely say we have successful changed the people’s mindset in the surrounding communities. Pregnant mothers used to shun this clinic preferring to deliver at home but not now. Every pregnant mother is coming here.”

Most members of the community can make salt and sugar solution, they fetch water for drinking from safe sources such as boreholes, they have pit toilets at their homesand they are also aware of the “three delays”.

These are the delay in deciding to seek care, the delay in reaching a health facility and the delay in receiving appropriate care.

“Here pregnant women are registering before three months because we taught them the importance of doing so and we continue to encourage them to follow all the necessary steps until even after birth,” said Anna Takaendesa, chairperson of CWGH in Chikwaka. “Very soon pregnant women will come and wait to delivery in the waiting mothers’ shelter built by the community.”

However, the country’s maternal and child mortality rates remain worrying.

It is estimated that 10 women and 100 children die every day due to largely preventable causes. Health experts say lack of information and awareness on maternal and child also contribute to the deaths.

Mupambawatye said religious objectors still remain an impediment as they discourage pregnant women from seeking medical attention or deliver safely at a health centre.

CWGH executive director Itai Rusike said Goromonzi was one of the districts where the people are enjoying the fruits of community participation in health.He said there was evidence that community-based approaches are effective in improving the health of individuals and communities at large.

“The state of primary health care has greatly improved here as direct result of community participation and health education. People here value their health,” Rusike told a meeting of HCC members at Mwanza Clinic recently.

The concept of community participation is increasingly being recognised as essential for realising the right to health. It entails that communities are no longer inactive recipients of health care but participants in the creation of health care systems that serve their specific needs.

A Study To Enhance Transparency And Accountability In The Management Of Health Related Issues In The Extractive Industries

A Study To Enhance Transparency And Accountability In The Management Of Health Related Issues In The Extractive Industries

CWGH with support from OSISA is undertaking this study in order to describe the current mining practices in Southern Africa including, Zimbabwe, Zambia, Mozambiuque, the Democratic Republic of Congo and Namibia with a special focus on community participation in mining. In this work, CWGH seeks to conduct a review of the use of health, social and environmental responsibility approaches to promote health-related actions in the operations of extractive industries – particularly relating to the health status of communities affected by the extractive industry. The review includes the effect of extractive industries on the health of surrounding communities, people employed in the industry and direct investment by extractive industries in health infrastructure and services for the communities they operate in through corporate responsibility.
The objectives of this work are:
I. To identify and analyse tools or mechanisms that are used to monitor the health impact of the mining sector in Zimbabwe.
II. To identify organizations which are directly or indirectly involved in the monitoring of health issues in the mining industries.
III. To propose areas for further research in an effort to understand the extent to which mining activities impact on the health of workers and communities.

Accountability Loop Budget Advocacy (ALBA) Programme

Accountability Loop Budget Advocacy – Pushing Zimbabwe’s Reproductive, Maternal, Newborn and Child Health (MNCH) agenda forward
ALBA is being implemented through a partnership that includes Community Working Group on Health (CWGH), Actionaid and Save the Children with support from the World Health Organization (WHO). The aim of the Accountability Loop Budget Advocacy is to ensure that pregnant women and children under 5 years old in Zimbabwe have access to free healthcare services through budget advocacy.
The project seeks to add value to the on-going national advocacy and media strategies of improving MNCH services in Zimbabwe. All activities are geared towards building momentum for the implementation of relevant national health policies and strategies such as the National Health Strategy of Zimbabwe, fulfillment of the 15% Abuja target and also advocating for incremental MNCH budget allocation for 2016.

Promoting Sexual Reproductive Health Rights for Young People

Promoting Sexual Reproductive Health Rights for Young People

Background

The CWGH Youth Programme was initiated in 2004 to equip young people with information and skills to address reproductive health issues affecting them.  The programme is being implemented in 10 of the CWGH areas namely: Tsholotsho, Gweru, Plumtree, Bulawayo, Arcturus, Hwange, Vic Falls, Mutare, Filabusi and Chiredzi. Young people are trained as peer educators and peer counsellors and equipped with knowledge and skills to enable them to disseminate information to their peers in a youth friendly environment.  Each area works closely with the CWGH committee and has an adult patron who is also a member of the committee.  
Presently only two areas, namely Bulawayo and Plumtree are funded. There are funded by TDH Germany and TDH Swiss respectively in partnership with the local authority. The remaining eight areas are still active but are mobilising resources locally to hold their activities.  
Each area`s activities are coordinated by an Executive Committee whose representatives make up the Youth Programme Executive, which meet every quarter to share and document best practices, review activities implemented and chart a way forward.  The Chairperson of this committee is represented at the CWGH Annual Meetings and ensures that there youth participation and input in the broader CWGH activities.  Most of the youths in the different areas are involved in other CWGH programmes hence there is an element of the youth programme in all of the CWGH work.  

Aim of the programme

The project aims to improve the Sexual and Reproductive Health Status of Young People by using of a three pronged strategy that ensures that youths attain Sexual Reproductive Health. Youths are also equipped with information, education and life-skills that will enable them to adopt and maintain positive health behaviours.  The programme builds the capacity of the community to provide life-skills and mentoring to youths through the inclusion of adults and representatives of community structures such as Child Protection Committees, Home Based Care Workers, Village Health Workers, the local and traditional leadership in all activities implemented.  The programme also empowers youths to make use of spaces and platforms to increase their participation in decision-making processes to influence change for positive health outcomes for youths and communities at large.

Project objectives

1.    To improve the Sexual and Reproductive Health Status of young people aged between 15 and 24 years.
2.    To strengthen the capacity of youths aged between 15 and 24 years to attain sexual reproductive health and psychosocial well-being through capacity development and participation.
3.    To equip youth with information, education and life skills on HIV/AIDS and Sexual Reproductive Health (SRH) for the adoption and maintenance of positive health behaviours.
4.    To strengthen the capacity of the community to provide life-skills and psycho-social care and support to youths, children and the community.
5.    To create Platforms for youths to discuss SRH issues and identify areas of concern that will influence SRH programming and policy formulation in responding to their needs.
6.    To increase young people`s self sufficiency and self-relieance by establishing nutritional gardens

Activities

The programme uses participatory methodologies such as Peer Education, Auntie Stella Toolkit, Join in Circuit, Use of Psychosocial Support Tools e.g. Memory Work, Journey of Life, Tre of Life etc.  The programme trains peer educators in SRH, HIV, STIs, basic counselling, child abuse so they are able to assist their peers to make informed decisions.  Peer educators man youth corners where sport, theatre, drama, talkshows, debated and focus group discussions are used to disseminate information to young people in a frienldy and relaxed atmosphere.  Youths also conduct basic counselling sessions but work closely with youth leaders, adult patrons, community structures, health centers and the ZRP, Victim Friendly Unit where they refer cases for further assistance.   Trained youths hold communinty health actions to address prioritised health challenges they face.  The health actions are supported by the office although some are funded by locally mobilised resources.  

Strengthening Social Accountability Monitoring and Responsiveness to Sexual and Reproductive Health Rights

Strengthening Social Accountability Monitoring and Responsiveness to Sexual and Reproductive Health Rights

The Strengthening Social Accountability Monitoring and Responsiveness to Sexual and Reproductive Health Rights (SRHR) is an Oxfam-funded project under the Securing Rights in the context of HIV and AIDS Programme (SRP).  The SRP initiative aims to mitigate the spread of HIV and AIDS and uphold the rights of people infected and affected by the epidemic, especially women and girls, persons with disabilities, young people, in particular those born and living with HIV and mobile populations to exercise their rights to prevention, quality treatment and care, and sustainable livelihoods.

The CWGH project mentors and supports five of the SRP partners in Matabeleland and Midlands region namely Youth for Today and Tomorrow (YTT), Umzingwane Aids Network (UAN), Hope for a Child in Christ (HOCIC), Midlands Aids Caring Organisation (MACO) and Million Memory Programmes Zimbabwe Trust (MMPZT) to strengthen their community monitoring mechanisms for health, particularly for HIV/AIDS resources and services. The project strengthens the capacity of the five CSOs to gather evidence on access to SHR and HIV services and resources and engage relevant authorities to demand for improved quality service provision and better equitable allocation of resources.

A bottom-up approach in influencing processes from local to national level is promoted through the use of available spaces such as community dialogues, pre and post budget meetings, Parliamentary Portfolio Committee on Health meetings. The mentorship process includes supporting CSOs to attend national advocacy meetings such as the CWGH National Conference as well as pre and post budget meetings. These provide the CSOs with an opportunity to engage different health authorities and policy makers to deliberate on and address problems faced by communities in accessing SRH and HIV services.  The advocacy actions are aimed pushing for the State`s social accountability and responsiveness to ensure that individuals have access to SRH, HIV and health services which are affordable, available and of high quality.  Accountability of the State is essential in ensuring equitable resource allocation and effective service delivery.

The media plays a pivotal role in this project by amplifying community voices for greater State responsiveness to the access of SRH, HIV and AIDS resources and services.  Positive reporting of health related stories has been adopted by journalists as evidenced by the number of articles published in the newspapers.  The project has also assists CSOs to get their community stories published through the Ministry Health and Child Care (MoHCC)’s Health Matters Magazine, which is distributed country wide.

Community Monitoring and Public Accountability for HIV/Aids Resources and Services

Community Monitoring and Public Accountability for HIV/Aids Resources and Services

The Public and Social Accountability work seeks to strengthen community capacity to monitor and advocate for improved availability and access to quality HIV/AIDS services. This is done through the work of Health Centre Committees (HCCs) and community monitors using community scorecards in two districts in the Midlands province of Zimbabwe, Kwekwe (urban) and Chiwundura (a rural sub district under the Gweru District administration).
The activities, implemented in communities, at district and national level, contribute to ensuring that there is an increase in public accountability and responsiveness of national HIV/AIDS institutions to the needs of people living with HIV.
Community-based monitoring, a promising practice for improving program effectiveness and a key component of the rights-based implementation of health programs, done by community monitors generates local evidence for engagement with duty bearers to address poor HIV/AIDS service delivery. Advocacy, a key component of the programme, is done through already existing platforms created for engagement at local and national level on issues of concern. These platforms include district stakeholder meetings at district level, where various government departments and civil society organizations convene to deliberate and address the problems presented by communities through HCCs.
Public discussions on topical health issues, pre and post budget meetings to influence national policies and resource allocation are some of the advocacy activities that are held at national level. These draw officials from government including Ministry of Health and Child Care (MoHCC), Parliament of Zimbabwe through the Parliamentary Portfolio Committee on Health (PPCH), Non Governmental Organizations (NGOs), academia and media.
The programme has made huge gains, particularly in improving relations between communities and health workers through the Patients’ Charter and influencing how resources for health are allocated to ensure equity. It has also contributed to improving some of the social determinants of health, such as water supply and sanitation.

Health Centre Committees (HCCs) as a vehicle for social participation in health in East and Southern Africa

Health Centre Committees (HCCs) as a vehicle for social participation in health in East and Southern Africa

The programme seeks to capacitate Health Centre Committees (HCCs) by strengthening advocacy, laws and approaches on a regional level. Encompassed in the overall goal of the programme is the principle that HCC roles should be clearly located within national health system processes.
As the lead organisation on the programme, CWGH is working in partnership with the Training and Research Support Centre (TARSC) on photovoice and information sharing; University of Cape Town (UCT) School of Public Health on training programmes; and the Lusaka District Health Management Team (LDHMT) on legal provisions.
Work in Kenya, Zambia, Malawi, South Africa, Uganda and Zimbabwe also focuses on advocating for policy and legal recognition of HCCs, giving visibility to their roles as well as identifying and strengthening the different capacities that committees and the health systems need for HCCs to implement these roles. This includes areas such as tracking and monitoring health system budgets and resources and their use and health system performance as well as building social dialogue and accountability.
As part of the work, UCT in South Africa is building a database of information on the current training materials and training programmes for HCCs to enable us to share materials, skills and experiences on capacity building in the region, and to advocate for HCC training that addresses their roles comprehensively. and their coverage of the key areas of functioning. LDHMT in Zambia has initiated an in-country process to review the laws and regulations that provide for the establishment and functioning of HCCs, and to document the Zambia experience for wider regional exchange. In Zimbabwe, the CWGH has supported the HCCs to engage with government, so that HCC members can speak out about their concerns on the health system and on the support they need to successfully implement their roles. Training on community photography by TARSC means that the members have visual tools as well as words to raise evidence on their problems and progress.
Social participation in health systems has been a consistent element of post-independence health policies in East and Southern Africa (ESA) countries and central to Primary Health Care (PHC) approaches that meet the health needs of target populations. A 2007 Regional Equity analysis done by the Regional Network for Equity in Health in East and southern Africa (EQUINET) highlighted that social participation and power are key for equitable health systems and for reclaiming and using resources for health. The report noted that regionally access to health care varies across countries, groups and individuals, largely influenced by social and economic conditions as well as health policies.

Strengthening Community Participation in Health (SCPH)

Strengthening Community Participation in Health (SCPH)

Zimbabwe’s maternal death rate dropped by 36% since 2009, but despite the progress over the past 5 years, it remains one of the highest in the world at 525 maternal deaths per 100 000 live births and 86 child deaths per 1000 live births. It is against this background that CWGH in partnership with Save the Children are implementing a 3 year project on Strengthening Community Participation in Health (SCPH) project. The project is in 21 districts across eight provinces in Zimbabwe, with support from DFID and EC.
The SCPH project aims to strengthen community engagement in health planning and service provision, with special emphasis on improving Maternal, Newborn and Child Health (MNCH) services. Through revitalizing Health Centre Committees (HCC’s) and strengthening community feedback mechanisms, the project has already achieved a positive impact on the quality and outcomes of MNCH services in the select provinces.  The project’s key activities also contribute to national level advocacy to meet Results Based Financing (RBF) targets for MNCH in Zimbabwe.
Beneficiaries of the project include; directly and indirectly; pregnant women, children under 5 years, HCCs/Community Monitors (CMs), Village Health Workers (VWHs)/Health Literacy Facilitators (HLFs), Health Workers and the general community through layered advocacy efforts which depend on issues coming out from the communities. The community level cadres have received comprehensive training to effectively use the set-up community feedback mechanism.
The project is rooted in the Theory of Change which targets notable improvements in the delivery of MNCH services in Zimbabwe through the achievement of four key results that follow a logical cycle:
    Result 1 will seek to raise the awareness of local communities to their rights and entitlement to health care. This result incorporates a strong communications focus and seeks to raise community knowledge and understanding of their rights and to initiate a culture of challenge to the status quo, rather than acceptance of poor standards and bad practices.
    Result 2 focuses on building the demand amongst communities for greater accountability through stronger and greater numbers of CHCs, use of community score cards and feedback mechanisms.
    Result 3 will build on this community capacity to engage with health providers and duty bearers to use feedback mechanisms and engage them in a partnership for change.
    Result 4 will use the data and information collected from the community level to inform and change institutional behaviors and policy decisions at the district and national levels.  

Get your priorities right, govt told

Get your priorities right, govt told

get_prioritiesHealth stakeholders have called on the government to get its priorities right by improving budget allocations towards the health sector, embarking on private public partnerships and plugging leakages within the sector.
The experts said if the government sets its priorities right, citizens’ access to facilities would be improved, thus ensuring quality health service delivery.

The Zimbabwe Medical Association (ZIMA) President, Dr Agnes Mahomva said private public partnerships should be taken seriously as they have been successfully implemented in other countries with better results.
“Government has for some time now misplaced its priorities regarding the provision of health facilities and services. Even workers need to be looked after,” she said.

Zimbabwe has failed to allocate the health sector the 15 percent requirement as espoused by the Abuja Declaration, with the sector getting an average 7 percent.

Community Working Group on Health Executive Director, Mr Itai Rusike said budget allocations to health should be increased.

Health and Child Care Parliamentary Portfolio Committee Chairperson, Dr Ruth Labode believes fraud and mismanagement of funds, wrong and misplaced priorities and leakages could be bleeding the sector.

The constitution of Zimbabwe guarantees the rights to health in Chapter 4 sections 76 and 77 where it states that every citizen and permanent resident of Zimbabwe has the right to have access to basic health-care services.

Every person living with a chronic illness has the right to have access to basic healthcare services for the illness according to the constitution.

 

Monday, 15 February 2016

‘Health board should lobby govt’

'Health board should lobby govt'

HARARE - The Health Services Board (HSB) should convince government of the importance of care workers and ensure that they are fully capacitated, the Community Working Group (CWG) on Health has said.
In an interview with the Daily News last week, CWG’s executive director Itai Rusike said HSB’s impact should be felt when they lobby government.
Minister of Health David Parirenyatwa revealed in Bulawayo recently that an estimated 3 500 nurses were unemployed.
He also noted that with the revised staff establishment, government would absorb all the unemployed nurses with room to employ an additional 5 000.
While world over standard nurse to patient ratio is 1 to 4, in Zimbabwe it is 1:15.
“The recent statistics show a worsening rather than improvement of some key health indicators that directly relate to population health and avoidance of preventable deaths,” he said.
Rusike added that the growth in population and disease burden should necessitate an increase in health workers so as to provide sufficient and quality services.
He said in some instances nurses cannot
undergo further training as their stations will be left empty due to a shortage of staff.
“However, even with the establishment levels, government is still unable to fill in the current establishment. For example most district hospitals do not have four doctors as required in the current establishment system,” Rusike said.
Zimbabwe Nurses Association has said that since most nurses have been unemployed for long periods of time, they need to go for refresher courses.

Helen Kadirire • 16 May 2016